MEDICARE: NICOLE GEORGE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP444609	PA

General Provider Information

NPI Number	:	1225342835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE GEORGE PHARMD

Provider Business Mailing Address
First Line	:	105 MALL BLVD
Second Line	:
City	:	MONROEVILLE
State	:	PA
Zip	:	15146-2230
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 CLEARVIEW CIR
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16001-1576
Country	:	US
Telephone Number	:	724-282-8113
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2010
Last Update Date	:	02/10/2014

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